G0069 Adm sq infusion drug in home

Professional services for the administration of subcutaneous immunotherapy or other subcutaneous infusion drug or biological for each infusion drug administration calendar day in the individual's home, each 15 minutes

Medicare pricing for G0069

Physician Fee Schedule (CY 2026, RVU26D)

Status X: statutory exclusion, not paid under the PFS.

Payer policies and prior authorization for G0069

Payer coverage policies that name G0069

G0069 appears in 14 coverage policies from Aetna, Anthem, UnitedHealthcare.

PayerPolicyRole in policyReviewedDocument
AetnaGraves' Ophthalmopathy Treatments (0419)
Celecoxib, Gypenosides, Pioglitazone		not coveredApr 23, 2026payer document
AetnaInfliximab (0341)listed, no stanceOct 5, 2026payer document
AetnaParenteral Immunoglobulins (0206)listed, no stanceOct 8, 2026payer document
AetnaSomatostatin Analogs (0693)listed, no stanceJul 15, 2026payer document
AnthemHome Health (CG-MED-23)covered if criteria are metNov 6, 2025payer document
UnitedHealthcareHome Health Care Services (for Kentucky Only) (CS137KY.12)listed, no stanceJul 1, 2026payer document
UnitedHealthcareHome Health, Skilled, and Custodial Care Services (MP.022.28)listed, no stanceJul 1, 2026payer document
UnitedHealthcareHome Health, Skilled, and Custodial Care Services (CS137.X)listed, no stanceJul 1, 2026payer document
UnitedHealthcareHome Health, Skilled, and Custodial Care Services (for Kansas Only) (CS137KS.04)listed, no stanceSep 1, 2026payer document
UnitedHealthcareHome Health, Skilled, and Custodial Care Services (for Nebraska Only) (CS137NE.V)listed, no stanceJan 1, 2026payer document
UnitedHealthcareHome Health, Skilled, and Custodial Care Services (for New Jersey Only) (CS137NJ.X)listed, no stanceSep 1, 2026payer document
UnitedHealthcareHome Health, Skilled, and Custodial Care Services (for New Mexico Only) (CS137NM.D)listed, no stanceSep 1, 2026payer document
UnitedHealthcareHome Health, Skilled, and Custodial Care Services (for Ohio Only) (CS137OH.E)listed, no stanceAug 1, 2026payer document
UnitedHealthcareHome Health, Skilled, and Custodial Care Services (for Tennessee Only) (CS137TN1.J)listed, no stanceJan 1, 2026payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN.

  • AZ: $223.83 (physician, AHCCCS PT 08, facility), effective Oct 1, 2019
  • ND: $0.00 (physician), effective Aug 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Apr 1, 2026
  • WA: $218.17 (physician, facility), effective Jul 1, 2026
  • WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), effective Apr 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.